AI Governance & Controls
How this workflow is kept safe, auditable, and accountable — Example Policy settings for a demonstration partner.
Approved data & knowledge sources
Meridian Benefits Overview Guide
Owner: Benefits Communications Team · Reviewed Aug 1, 2026
Employment Status Change FAQ
Owner: Benefits Communications Team · Reviewed Aug 10, 2026
Enrollment Policy v3.2
Owner: Compliance Team · Reviewed Jul 15, 2026
Legacy Response Template Set
Owner: Member Experience Team · Reviewed Mar 1, 2026
Prompt & policy version history
Escalation & Routing Policy v1.3 (effective Aug 2026)
Updated routing language for financial-hardship and urgent-timing triggers.
Plain-language rewrite pass applied to all specialist-routing explanations.
Initial governed release with approved-source grounding and human-in-the-loop routing.
Role-based access control
Partner Administrator
Configure branding and programs · Manage routing rules and SLAs · View partner-level analytics · Manage content source approvals
Specialist Reviewer
View and act on assigned queue items · Send approved responses · Reassign and escalate cases · Flag interactions for quality review
Platform Operations
View governance and audit controls · Manage prompt and policy versions · Monitor model/response indicators · Manage retention and consent settings
Member
Start guided support conversations · View own request history · Request data deletion
Data minimization rules
- Only program-relevant context is collected during guided intake.
- No sensitive personal identifiers are requested unless required for a specialist handoff.
- Free-text fields are reviewed for unnecessary sensitive information before storage.
Retention & deletion settings
Example Policy — placeholder values for this demonstration.
Conversation transcripts
90 days · Automatic purge
Structured handoff summaries
1 year · Automatic purge, audit log retained
Audit trail records
3 years · Archived, then purged
Consent & notice controls
- Member notice shown before the first guided conversation begins.
- Explicit member consent required before handoff to a human specialist.
- Members can request deletion of their conversation data at any time.
Interaction audit trail
| When | Actor | Action |
|---|---|---|
| Aug 25, 8:15 AM | System | Handoff created for Taylor Reyes (Medium priority, Benefits Navigator Team). |
| Aug 24, 3:22 PM | Priya Anand | Claimed case for Jordan Blake; status changed to In Review. |
| Aug 24, 7:50 PM | Sofia Delgado | Marked Casey Nakamura case Resolved after guided account recovery. |
| Aug 23, 11:10 AM | Marcus Webb | Requested additional information from Riley Thompson; status set to Awaiting Member. |
| Aug 20, 9:00 AM | Platform Operations | Published Prompt & Policy version v2.4. |
Quality assurance
6 interactions in the QA review queue
Flagged interaction categories
- · Ambiguous eligibility language
- · Low source-confidence responses
- · Repeat escalations on the same topic
Exception-management workflow
Interactions flagged for low source confidence, ambiguous routing, or member-reported dissatisfaction are queued for Specialist Reviewer sign-off before the AI-suggested response is used again as a pattern. Platform Operations reviews exception trends weekly and can retire or revise a prompt/policy version.
Model / response monitoring
Response grounding rate
96%
NormalAbstention rate
4.2%
WatchEscalation routing accuracy
98%
NormalFlagged-interaction rate
1.8%
Normal